Become a part of our caring community and help us put health first
 

The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Senior Process Improvement Professional analyzes and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

• Responsible for initiating, developing, and recommending best business practices and procedures for physical health clinical and nonclinical team processes

• DRI for overseeing revamp, maintenance and governance of Clinical Operations SharePoint site.

• Ensures operational processes align with governing and NCQA requirements. 

• Executes on process improvement/development and evaluation strategy and analyzes results

• Makes recommendations for improvement based on analysis of results

• Works with process improvement team to create processes and provide direction on implementation of process.  This includes, but is not limited to things such as creating processes and executing on process roll out and communication, tracking implementation of processes

• Evaluates processes to ensure up-to-date and works with trainers to ensure ability of associates to perform needed skills.

• Provides coaching and feedback and develops other process improvement team members to deliver consistent process improvement experiences across all clinical operations processes.

Subject Matter Expertise Coordination

• Develop/leverage subject expertise on systems and processes that support Humana Healthy Horizons National Operations team to lead content direction for learning and development efforts

• Build relationships with other subject matter experts and engage them when appropriate to contribute content for process design and developmental efforts

• Develop cross-functional relationships with other process functions to leverage existing processes to meet clinical needs.  Share information and content developed for clinical curriculum to other areas that support the clinical area.

• When needed, work with learning facilitators to design and develop training materials with support from learning consultants

Use your skills to make an impact
 

Required Qualifications

• Associate's degree or 5 years combination clinical process improvement and quality experience

• Intermediate to Advanced proficiency with the ability to navigate multiple screens and databases with proficiency with Microsoft Office (Excel, Word, Power Point, Lucid) and other virtual platforms i.e. Zoom and Teams

• Experience with creating data presentations in the form or graphs/charts/graphics

• Experience with creating and maintaining SharePoint sites

• Minimum 2 years Medicare/Medicaid or Healthcare experience in Utilization Management

• Great Communication Skills -Written and Verbal

• Emotional Intelligence

Preferred Qualifications

• Knowledge or certificates Project and Process Methodologies, (Lean Six, Project Management)

• Bachelor's Degree

Workstyle: Remote work at Home

Location: Nationwide

Schedule:

• Typically, Monday through Friday 8:30 AM -5:30 PM Eastern time and may fluctuate during high demand business needs.

• Weekends may be required and will be discussed at interview.

Travel:

• Limited

Work at Home Guidance To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following